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Back  RFI # 640: CPT Code line amounts

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Submitter

Matthew Tarpley

Description

When filing an electronic claim and entering the CPT codes is it a requirement to enter a dollar amount for every code or will a total amount suffice?

Response

The total charge amount for the claim (CLM02) must equal the total of submitted charges on the service lines. While one or more of the line charges may be zero in certain uses of the transaction, that does not alter the requirement that the sum of the line amounts must equal the claim amount. Therefore, there can not be a charge included in the total claim amount that is not reflected in a line charge amount.
Submission 3/28/2008
Status Date 6/17/2008
Status F - Final
Primary References
Document 004010X096A
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Page8
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